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Prevalence of triple negative breast cancer (TNBC) and immunophenotyping in the pathology laboratory of Dr. Shariati hospital in 2008-2012.


Breast cancer is the most common female cancer. It affects more than 1 million women worldwide and about 400,000 patients die due to this disease every year. The second most common cause of cancer deaths due to breast cancer [1]. Breast cancer is a heterogeneous disease, which can be characterized into clinically, morphologically and biologically different groups. There has been recent intense interest in the subset of breast cancer referred to as triple-negative breast cancer that lacks the expression of hormone receptors and HER2(cerbB2). Surgery and chemotherapy are the main methods for cancer treatment. Methods and specific targeted chemotherapy drugs in patients who require targeted receptors (ER, PR, HER2neu) a specific response of cancer cells to chemotherapy. Triple-negative breast cancer has more aggressive clinical behavior [2-5] distinctive metastatic patterns [6-7] and poor prognosis (7, 8). Triple-negative breast cancer accounts for 10-17% of all breast carcinomas depending on thresholds used to define estrogen receptor (ER) and progesterone receptor (PR) positivity, as well as methods and criteria for HER2 assessment [8-13]. This group is very important to identify clinically because in this group, routine chemotherapy is of no use. Efforts have been made to identify more accurately the group that led to the identification of subgroups of breast cancer such as basal-like which is important in terms of prognosis [1].

However, no information is available about this important group in Iran. In the first step, the prevalence of TNBC in an academic referral center for patients of breast cancer throughout the country in order to determine the immunohistochemical evaluation plan will be submitted to chemotherapy, it seems logical. Accurate detection and determination of this group basal, great value for clinicians in order to provide accurate and effective chemotherapy will follow.

Our study aimed prevalence triple-negative breast cancer and basal-like breast cancers in our population.


The study was descriptive and Case-series. The study population included all patients with breast cancer between 2008 and 2012 in the Department of Pathology, Shariati Hospital, Tehran, disease has been diagnosed, or are referred to this center for IHC. As to the conducted of breast cancer specimens referred to the Department of Pathology, Shariati Hospital between 2008 and 2012 to investigate the primary IHC for ER, PR, HER2neu. Among them samples of markers ER, PR, HER2neu be negative (TNBC), prevalence was determined. Then CK14, EGFR, 34[beta]E12 used to identifying subgroups of basal-like breast cancers. Finally, all the results evaluated using the descriptive indicators and T-test (comparison of age) by statistical software SPSS 19.


Of 586 breasts cancer patients with a mean age of 47.01 [+ or -] 4.19 by early IHC test for markers ER, PR, HER2neu were studied.. The test indicated that 90 patients (15.35%) for three markers ER, PR, HER2neu were negative. with an average age of 35.5. [+ or -] 2.12. Then 3 markers of CK14, EGFR, 34PE12 with 100% sensitivity and 78% specificity in identifying basal-like subgroups f breast used, showed that 69 patients (76.6%) for the three marker CK14, EGFR, 34PE12 were positive. (Table 1)


According to the results it can be seen that the average age of patients was 47.01 years of age is slightly lower than the numbers listed in the references. [14] Total of 586 patients, 90 cases (15.35%) of the markers ER, PR, HER2neu were negative (TNBC). The prevalence of TNBC with countries such as Japan [15] Korea [16] are almost compatible. But other studies is inconsistent with the present study [1]. In Review of TNBC basal-like breast cancers markers CK14, EGFR, 34PE12 showed that 76.6% (69 out of 90 patients) were positive for these markers. Thike et al study was consistent with these results, so that the study of the prevalence of these markers in patients with TNBC, 70 percent is shown [1]. Overall since basal-like breast cancers markers (CK14, EGFR, 34[beta]E12) determining role in the prognosis and treatment of patients with breast cancer. We recommended For all primary breast cancer diagnosed as TNBC in primary evaluation, basal markers immunophenotyping should proceed.


Article history:

Received 25 March 2014

Received in revised form 20 April 2014

Accepted 15 May 2014

Available online 5 June 2014


[1] Thike, A.A., P.Y. Cheok, A.R. Jara-Lazaro, B. Tan, P. Tan, P.H. Tan, 2010. Triple-negative breast cancer: clinicopathological characteristics and relationship with basal-like breast cancer. Modern pathology, 23(1):123-33.

[2] Brenton, J.D., L.A. Carey, A.A. Ahmed, C. Caldas, 2005. Molecular classification and molecular forecasting of breast cancer: ready for clinical application? Journal of Clinical Oncology, 23(29):7350-60.

[3] Nielsen, T.O., F.D. Hsu, K. Jensen, M. Cheang, G. Karaca, Z. Hu, et al., 2004. Immunohistochemical and clinical characterization of the basal-like subtype of invasive breast carcinoma. Clinical Cancer Research, 10(16):5367-74.

[4] Sorlie, T., C.M. Perou, R. Tibshirani, T. Aas, S. Geisler, H. Johnsen, et al., 2001. Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proceedings of the National Academy of Sciences, 98(19):10869-74.

[5] Van De Rijn, M., C.M. Perou, R.Tibshirani, P. Haas, O. Kallioniemi, J. Kononen, et al., 2002. Expression of cytokeratins 17 and 5 identifies a group of breast carcinomas with poor clinical outcome. The American journal of pathology, 161(6): 1991-6.

[6] Fulford, L.G., J.S. Reis-Filho, K. Ryder, C. Jones, C.E. Gillett, A. Hanby, et al., 2007. Basal-like grade III invasive ductal carcinoma of the breast: patterns of metastasis and long-term survival. Breast Cancer Research, 9(1):R4.

[7] Hicks, D.G., S.M. Short, N.L. Prescott, S.M. Tarr, K.A. Coleman, B.J. Yoder, et al., 2006. Breast cancers with brain metastases are more likely to be estrogen receptor negative, express the basal cytokeratin CK5/6, and overexpress HER2 or EGFR. The American journal of surgical pathology, 30(9):1097-104.

[8] Carey, L.A., E.C. Dees, L. Sawyer, L. Gatti, D.T. Moore, F. Collichio, et al., 2007. The triple negative paradox: primary tumor chemosensitivity of breast cancer subtypes. Clinical Cancer Research, 13(8): 2329-34.

[9] Dent, R., M. Trudeau, K.I. Pritchard, W.M. Hanna, H.K. Kahn, C.A. Sawka, et al. 2007. Triple-negative breast cancer: clinical features and patterns of recurrence. Clinical Cancer Research, 13(15):4429-34.

[10] Haffty, B.G., Q. Yang, M. Reiss, T. Kearney, S.A. Higgins, J. Weidhaas, et al., 2006. Locoregional relapse and distant metastasis in conservatively managed triple negative early-stage breast cancer. Journal of Clinical Oncology, 24(36): 5652-7.

[11] Harris, L.N., G. Broadwater, N.U. Lin, A. Miron, S.J. Schnitt, D. Cowan, et al., 2006. Molecular subtypes of breast cancer in relation to paclitaxel response and outcomes in women with metastatic disease: results from CALGB 9342. Breast Cancer Res, 8(6): R66.

[12] Rakha, E.A., M.E. El-Sayed, A.R. Green, A.H. Lee, J.F. Robertson, I.O. Ellis, 2007. Prognostic markers in triple-negative breast cancer. Cancer, 109(1): 25-32.

[13] Tischkowitz, M., J.S. Brunet, L.R. Begin, D.G. Huntsman, M.C. Cheang, L.A. Akslen, et al., 2007. Use of immunohistochemical markers can refine prognosis in triple negative breast cancer. BMC cancer, 7(1):134.

[14] Robbins, S.L., R.S. Cotran, 1979. Pathologic basis of disease: Saunders.

[15] Iwase, H., J. Kurebayashi, H. Tsuda, T. Ohta, M. Kurosumi, K. Miyamoto, et al., 2010. Clinicopathological analyses of triple negative breast cancer using surveillance data from the Registration Committee of the Japanese Breast Cancer Society. Breast Cancer, 17(2):118-24.

[16] Rhee, J., S.W. Han, D.Y. Oh, J.H. Kim, S.A. Im, W. Han, et al., 2008. The clinicopathologic characteristics and prognostic significance of triple-negativity in node-negative breast cancer. BMC cancer,;8(1): 307.

(1) Esmaeil Samizadeh, (2) Zahra Forouhesh, (3) Naser kamalian

(1) Resident of pathology, Shariati hospital, pathology department Tehran Universiti of Medical Science (TUMS), Tehran, Iran

(2) Associate professor of pathology, Shariati hospital, pathology department Tehran Universiti of Medical Science (TUMS), Tehran, Iran

(3) Professor of pathology, Shariati hospital, pathology department Tehran Universiti of Medical Science (TUMS), Tehran, Iran

Corresponding Author: Esmaeil Samizadeh, Resident of pathology, Shariati hospital, pathology department Tehran Universiti of Medical Science (TUMS), Tehran, Iran.
Table 1: Frequency distributionand percentageis basal-like
breast cancers markers in 90 patients with TNBC.

Basal     Positive     Negative     Total
marker    Frequency    Frequency    Frequency
          (%)          (%)          (%)

34PE12    (81.11)73    (18.89)17    (100)90
EGFR      (77.78)70    (22.22)20    (100)90
CK14      (77.78)70    (22.22)20    (100)90

Mean age of TNBC group was 35.5 [+ or -] 2.12 and was
significantly different than Non-TNBC group 48.1 [+ or -] 3.11
(P < 0.001).
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Author:Samizadeh, Esmaeil; Forouhesh, Zahra; kamalian, Naser
Publication:Advances in Environmental Biology
Article Type:Report
Geographic Code:7IRAN
Date:Jun 20, 2014
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